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World J Gastroenterol. Aug 7, 2026; 32(29): 116893
Published online Aug 7, 2026. doi: 10.3748/wjg.116893
Published online Aug 7, 2026. doi: 10.3748/wjg.116893
Impact of computer-aided polyp detection in screening and diagnostic colonoscopy: A multicenter randomized controlled trial
Gian Eugenio Tontini, Giovanni Aldinio, Giulia Picardi, Matilde Topa, Maurizio Vecchi, Luca Elli, Department of Pathophysiology and Organ Transplantation, University of Milan, Milan 20122, Lombardy, Italy
Gian Eugenio Tontini, Francesco Conforti, Emanuele Dabizzi, Lucia Scaramella, Maurizio Vecchi, Luca Elli, Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan 20122, Lombardy, Italy
Lorenzo Dioscoridi, Irene Cottone, Massimiliano Mutignani, Digestive and Interventional Endoscopy Unit, ASST Niguarda, Milan 20162, Lombardy, Italy
Raffaele Salerno, Beatrice Mantia, Mario Schettino, Division of Gastroenterology, ASST Fatebenefratelli Sacco, Milan 20162, Lombardy, Italy
Matteo Rossano Buonocore, Fabio Monica, Department of Gastroenterology and Digestive Endoscopy, Academic Hospital Cattinara, Trieste 34149, Friuli Venezia Giulia, Italy
Paola Cesaro, Nicola Olivari, Daniele Salvi, Gastroenterology and Digestive Endoscopy Unit, Poliambulanza Brescia Hospital, Brescia 25124, Lombardy, Italy
Dario Consonni, Occupational Health Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano 20122, Lombardy, Italy
Author contributions: Tontini GE, Dioscoridi L, Salerno R, Vecchi M, and Elli L contributed to conceptualization; Consonni D contributed to data curation and formal analysis; Tontini GE, Dioscoridi L, Salerno R, Aldinio G, Buonocore MR, Cesaro P, Conforti F, Cottone I, Dabizzi E, Mantia B, Monica F, Mutignani M, Olivari N, Salvi D, Scaramella L, Schettino M, Topa M, Vecchi M, and Elli L contributed to investigation; Tontini GE, Consonni D, Vecchi M, and Elli L contributed to methodology; Tontini GE, Vecchi M, and Elli L contributed to project administration and supervision; Tontini GE, Dioscoridi L, Salerno R, Vecchi M, and Elli L contributed to validation; Tontini GE, Dioscoridi L, Salerno R, Aldinio G, Topa M, Vecchi M, and Elli L contributed to visualization; Tontini GE, Dioscoridi L, Salerno R, Aldinio G, Buonocore MR, Cesaro P, Conforti F, Consonni D, Cottone I, Dabizzi E, Mantia B, Monica F, Mutignani M, Olivari N, Picardi G, Salvi D, Scaramella L, Schettino M, Topa M, Vecchi M, and Elli L contributed to writing of original draft, and review and editing. All authors have read and approve the final manuscript.
Supported by Italian Ministry of Education and Research - MUR; Italian Ministry of Health, No. RC2026/150/01.
Institutional review board statement: The research protocol was reviewed and approved by the Institutional Review Board of Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, No. OSMAMI-15/09/2022-0042892-U.
Clinical trial registration statement: The trial was registered on ClinicalTrials.gov, No. NCT07171333.
Informed consent statement: Written informed consent was obtained from all participants prior to their inclusion in the study, in accordance with the ethical standards of the Declaration of Helsinki.
Conflict-of-interest statement: Dr. Tontini reports PENTAX Medical Europe loaned the DISCOVERY™ systems for the duration of the study.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Data collected with deidentified participants will be available from the corresponding author upon request.
Corresponding author: Gian Eugenio Tontini, MD, PhD, Assistant Professor, Department of Pathophysiology and Organ Transplantation, University of Milan, Via della Commenda 19, Milan 20122, Lombardy, Italy. gianeugenio.tontini@unimi.it
Received: November 24, 2025
Revised: February 13, 2026
Accepted: April 22, 2026
Published online: August 7, 2026
Processing time: 235 Days and 21.7 Hours
Revised: February 13, 2026
Accepted: April 22, 2026
Published online: August 7, 2026
Processing time: 235 Days and 21.7 Hours
Core Tip
Core Tip: This study shows that in tertiary centers, computer-aided detection (CADe) did not enhance overall polyp or adenoma detection compared with conventional, ultra-high-definition colonoscopy. High-volume endoscopists did not benefit and in some cases performed slightly worse with CADe. Indicators of operator fatigue did not significantly influence CADe effectiveness.